MEDICARE: DR. ANNA E DRZEWIECKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	0101049717	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	380509	OTHER	VA	ANTHEM BCBS
2	54047	OTHER	VA	SENTARA OPTIMA
3	541858799	OTHER		TRICARE
4	541858799	OTHER		VIRGINIA HEALTH NETWORK

General Provider Information

NPI Number	:	1538216478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA E DRZEWIECKI MD

Provider Business Mailing Address
First Line	:	1856 COLONIAL MEDICAL CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3075
Country	:	US
Telephone Number	:	757-481-4969
Fax Number	:	757-481-9373

Provider Business Practice Location Address
First Line	:	1856 COLONIAL MEDICAL CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3075
Country	:	US
Telephone Number	:	757-481-4969
Fax Number	:	757-481-9373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	11/16/2011

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